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The gray area between operational tolerance and overt rejection in kidney transplantation

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Resumo:ABSTRACT Operational tolerance in kidney transplantation is characterized by stable serum creatinine < 1.7 mg/dL and proteinuria < 1 g/day in the absence of immunosuppression or immunodeficiency for over one year. However, simultaneous donor specific antibodies are common and serum creatinine is a poor surrogate of early lesions. Consequently, subclinical rejections will meet operational tolerance criteria if sérum creatinine remains stable. We report a patient with operational tolerance criteria followed by biopsy-proven chronic active antibody mediated rejection, discussing the intricate challenges of immunosuppression management.
Autores principais:Silva,Rui F.
Outros Autores:Relvas,Miguel L.; Nunes,Ana; Silvano,José L.; Beco,Ana; Bustorff,Manuela B.; Sampaio,Susana M.
Assunto:kidney transplantation operational tolerance antibody mediated rejection
Ano:2021
País:Portugal
Tipo de documento:relatório
Tipo de acesso:acesso aberto
Instituição associada:Fundação para a Ciência e Tecnologia
Idioma:português
Origem:SciELO Portugal
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author Silva,Rui F.
author2 Relvas,Miguel L.
Nunes,Ana
Silvano,José L.
Beco,Ana
Bustorff,Manuela B.
Sampaio,Susana M.
author2_role author
author
author
author
author
author
author_facet Silva,Rui F.
Relvas,Miguel L.
Nunes,Ana
Silvano,José L.
Beco,Ana
Bustorff,Manuela B.
Sampaio,Susana M.
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Silva,Rui F.\"},{\"Person.name\":\"Relvas,Miguel L.\"},{\"Person.name\":\"Nunes,Ana\"},{\"Person.name\":\"Silvano,José L.\"},{\"Person.name\":\"Beco,Ana\"},{\"Person.name\":\"Bustorff,Manuela B.\"},{\"Person.name\":\"Sampaio,Susana M.\"}]
datacite.creators.creator.creatorName.fl_str_mv Silva,Rui F.
Relvas,Miguel L.
Nunes,Ana
Silvano,José L.
Beco,Ana
Bustorff,Manuela B.
Sampaio,Susana M.
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv kidney transplantation
operational tolerance
antibody mediated rejection
datacite.titles.title.fl_str_mv The gray area between operational tolerance and overt rejection in kidney transplantation
dc.creator.none.fl_str_mv Silva,Rui F.
Relvas,Miguel L.
Nunes,Ana
Silvano,José L.
Beco,Ana
Bustorff,Manuela B.
Sampaio,Susana M.
dc.format.none.fl_str_mv text/html
dc.identifier.none.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000400260
dc.language.none.fl_str_mv por
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.source.none.fl_str_mv Portuguese Journal of Nephrology &amp; Hypertension v.35 n.4 2021
dc.subject.none.fl_str_mv kidney transplantation
operational tolerance
antibody mediated rejection
dc.title.fl_str_mv The gray area between operational tolerance and overt rejection in kidney transplantation
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_93fc
description ABSTRACT Operational tolerance in kidney transplantation is characterized by stable serum creatinine < 1.7 mg/dL and proteinuria < 1 g/day in the absence of immunosuppression or immunodeficiency for over one year. However, simultaneous donor specific antibodies are common and serum creatinine is a poor surrogate of early lesions. Consequently, subclinical rejections will meet operational tolerance criteria if sérum creatinine remains stable. We report a patient with operational tolerance criteria followed by biopsy-proven chronic active antibody mediated rejection, discussing the intricate challenges of immunosuppression management.
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identifier.url.fl_str_mv http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000400260
instacron_str SciELO
institution Fundação para a Ciência e Tecnologia
instname_str Fundação para a Ciência e Tecnologia
language por
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network_name_str SciELO Portugal
oai_identifier_str oai:scielo:S0872-01692021000400260
organization_str_mv urn:organizationAcronym:scielo
person_str_mv Silva,Rui F.
Relvas,Miguel L.
Nunes,Ana
Silvano,José L.
Beco,Ana
Bustorff,Manuela B.
Sampaio,Susana M.
publishDate 2021
publisher.none.fl_str_mv Sociedade Portuguesa de Nefrologia
reponame_str SciELO Portugal
repository_id_str urn:repositoryAcronym:scielopt
service_str_mv urn:repositoryAcronym:scielopt
spelling The gray area between operational tolerance and overt rejection in kidney transplantationSilva,Rui F.Relvas,Miguel L.Nunes,AnaSilvano,José L.Beco,AnaBustorff,Manuela B.Sampaio,Susana M.kidney transplantationoperational toleranceantibody mediated rejectionopen accesshttp://purl.org/coar/access_right/c_abf2http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000400260URLhttp://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000400260URLHasVersion2021-12-01ABSTRACT Operational tolerance in kidney transplantation is characterized by stable serum creatinine < 1.7 mg/dL and proteinuria < 1 g/day in the absence of immunosuppression or immunodeficiency for over one year. However, simultaneous donor specific antibodies are common and serum creatinine is a poor surrogate of early lesions. Consequently, subclinical rejections will meet operational tolerance criteria if sérum creatinine remains stable. We report a patient with operational tolerance criteria followed by biopsy-proven chronic active antibody mediated rejection, discussing the intricate challenges of immunosuppression management.Sociedade Portuguesa de NefrologiaPortuguese Journal of Nephrology &amp; Hypertension v.35 n.4 2021text/htmlporreporthttp://purl.org/coar/resource_type/c_93fcother research product
spellingShingle The gray area between operational tolerance and overt rejection in kidney transplantation
Silva,Rui F.
kidney transplantation
operational tolerance
antibody mediated rejection
status SINGLETON
subject.fl_str_mv kidney transplantation
operational tolerance
antibody mediated rejection
title The gray area between operational tolerance and overt rejection in kidney transplantation
title_full The gray area between operational tolerance and overt rejection in kidney transplantation
title_fullStr The gray area between operational tolerance and overt rejection in kidney transplantation
title_full_unstemmed The gray area between operational tolerance and overt rejection in kidney transplantation
title_short The gray area between operational tolerance and overt rejection in kidney transplantation
title_sort The gray area between operational tolerance and overt rejection in kidney transplantation
topic kidney transplantation
operational tolerance
antibody mediated rejection
topic_facet kidney transplantation
operational tolerance
antibody mediated rejection
url http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692021000400260
visible 1